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Центр пластической хирургии НанаНаучные публикации




Plastic and
Reconstructive Surgery Хванг Донг Йон

  • A Modified Dual-plane Technique Using the Serratus Anterior Fascia in Primary Breast Augmentation.
  • Хванг Донг Йон
  • 2017 Feb
  • 22;5(2):e1213

JPRASХванг Донг Йон

  • Correction of facial linear scleroderma 'coup de sabre' with BoneSource.
  • Dong Yeon Hwang
  • 2009 Feb
  • 62(2):e25-8

THE JOURNAL OF CRANIOFACIAL SURGERY Хванг Донг Йон

  • Multiple huge epidermal inclusion cysts mistaken as neurofibromatosis.
  • Хванг Донг Йон
  • 2008 Nov
  • 19(6):1683-6

THE JOURNAL OF CRANIOFACIAL SURGERY Ким Хёнг Джун

  • Reconstruction of scalp defect after Moyamoya disease surgery using an occipital pedicle V-Y advancement flap.
  • Ким Хёнг Джун
  • 2008 Jul
  • 19(4): 1075-9

Archives of Plastic SurgeryКим Хёнг Джун

  • Treatment of Chronic Wound in a Patient with Systemic Vasculitis.
  • Ким Хёнг Джун
  • 2006 Jan
  • 33(1)

Archives of Plastic SurgeryКим Хёнг Джун

  • Erysipelas of the Upper Extremity Following Surgical Therapy for Breast Cancer.
  • Ким Хёнг Джун
  • 2007 Jan
  • 34(1)

Archives of Craniofacial Surgery Ким Хёнг Джун

  • A Case of Lipoma of the Parotid Gland
  • Ким Хёнг Джун
  • 2007 Apr
  • 8(1)

Plastic and
Reconstructive SurgeryПак Сеон Хьюй

  • The usability of the upper eyelid crease approach for correction of medial orbital wall blowoutfracture.
  • Пак Сеон Хьюй
  • 2012 Oct
  • 130(4):898-905

Br J Oral Maxillofac SurgПак Сеон Хьюй

  • V-Y-Z plasty for correcting cryptotia.
  • Пак Сеон Хьюй
  • 2009 Oct
  • 47(7):562-3..

Archives of Craniofacial Surgery Пак Сеон Хьюй

  • Aggressive Squamous Cell Carcinoma of the Scalp with Invasion into the Skull and Dura Mater.
  • Пак Сеон Хьюй
  • 2009
  • Vol. 10 NO.2

Archives of Plastic Surgery Пак Сеон Хьюй

  • Spindle Cell Lipoma of the Posterior Neck: A Case Report.
  • Пак Сеон Хьюй
  • 2009
  • pp. 233-236

Archives of Plastic SurgeryПак Сеон Хьюй

  • A case of DiGeorge syndrome with metopic synostosis.
  • Пак Сеон Хьюй
  • 2011, Vol.38 No.1

A Modified Dual-plane Technique Using the serratus Anterior Fascia in Primary Breast Augmentation.



BACKGROUND
Breast augmentations are commonly performed aesthetic surgical procedures. As the breast is a changeable structure, the ideal location of an implant would be a plane that can adjust to the dynamic changes of the breast. We present a modified dual-plane technique for breast augmentation using the fascia for thin patients.

METHODS
Between June 2014 and June 2015, 27 patients with small breasts underwent breast augmentation using the modified dual-plane technique. The average age was 29.4 years (range, 20-41 y). The mean body mass index was 18.9 kg/m2 (range, 17.6-20.4 kg/m2).

RESULTS
The mean size of the implant was 288.9 ml (range, 255-360 ml) on the right side and 281.6 ml (range, 255-360 ml) on the left side. All the patients returned to daily-life activities within 1 week. There have been no complicati ons during minimum follow-up periods of 18 months. The mean follow-up was 25.6 months (range, 18-36 mo).

CONCLUSIONS
Visible, palpable implants and rippling after breast augmentation with implants are relatively common problems. Our modified dual-plane technique with the serratus anterior fascia can reduce visible rippling and yields a natur al-looking breast, especially in thin patients.

Correction of facial linear scleroderma 'coup de sabre' with BoneSource.



Linear scleroderma is a subtype of localised scleroderma. When linear scleroderma occurs on the anterior portion of the scalp and forehead, it may assume an ivory-like, depressed configuration similar to the stroke of a sabre and called 'coup de sabre'. Atrophic changes affect subcutaneous tissue and skin, with later involvement of the muscles and osteocartilaginous framework. Various operative interventions, such as skin flap, fat graft, dermofat graft and bone graft could be used for correction of this deformity, but there is no definite satisfactory treatment modality. We report the case of a 19-year-old female with a band-like indurated skin lesion with depression in the frontoparietal region of the scalp. Through bicoronal incision and subperiosteal dissection the defect was fully exposed. The depressive lesion was slightly hyperaugmented using BoneSource (calcium phosphate hydroxyapatite cement; Stryker Leibinger Corp., Kalamazoo, MI, USA), considering skin and soft tissue atrophy. Surgical outcome was excellent in cosmetic and functional aspects without any complication. The patient was followed for 36 months after the operation; the defect was satisfactorily corrected and no postoperative problems have been found.

Multiple huge epidermal inclusion cysts mistaken as neurofibromatosis.



Epidermal inclusion cyst is one of the common benign soft tissue tumors, and it can be easily confirmed and treated by surgical excision. We experienced a patient who had multiple masses on the face and scalp region, and the masses had been misdiagnosed as neurofibromatosis because of accompanying mental retardation. We would like to introduce a case of clinical diagnosis error caused by the lack of radiologic evaluation and pathologic confirmation. A 27-year-old male patient visited with multiple masses, with a length of approximately 1 to 10 cm on the face and scalp region. These mass have developed since childhood without known etiology, and there has been no histologic examination or surgical excision done in the past. The patient's history of seizure disorder and mental retardation led the primary clinician to diagnose it as neurofibromatosis in the initial stage, and therefore, the clinician gave an advice on the possibility of frequent recurrence to the patient. As the masses increased in size, the patient came to our hospital after all. We found that the masses were soft and mobile through the physical examination, and magnetic resonance imaging showed evidence of epidermal inclusion cyst, which is distinguished from neurofibromatosis. Based on physical examination and magnetic resonance imaging, we performed total excision and biopsies. On the histologic examination, it was diagnosed as an epidermal inclusion cyst showing keratotic material internally, and the cyst wall was composed of lamellate keratin. The follow-up period was 12 months, and a recurrence has not occurred. The wound was healed without any specific complication, and both the patient and the guardian were satisfied with the physical enhancement. We have observed a misdiagnosed case that was misconceived by the situation, accompanying mental retardation. Due to this misconception, any surgical treatment was not performed at all, and the symptoms eventually worsened as multiple huge epidermal inclusion cysts. We present this case with a brief review of literature.

Reconstruction of scalp defect after Moyamoya disease surgery using an occipital pedicle V-Y advancement flap.



Scalp necrosis is an infrequent complication of Moyamoya disease surgery, which is more prevalent in the parietotemporal area. Because scalp vascularity is severely compromised after Moyamoya disease surgery, reconstructio n of defects with local scalp tissue is challenging. To cover defects, a flap is needed that is highly vascularized and has great mobility and territory to avoid existing scars. After tracing ipsilateral occipital artery, an advancement flap that was based on occipital artery and vein was designed to fit the defect. The flap was elevated in the subperiosteal layer and advanced without tension to cover the defect. Occipital pedicle V-Y advancement flaps were use d in 7 patients who had scalp necrosis of the parietotemporal area and a mean defect size of 8.7 cm. There were no complications such as flap necrosis, infection, or recurrence of defect in all patients during 9-month follow-up. Occipital pedicle V-Y advancement flap is a useful alternative flap for scalp defects after surgical treatments that compromise scalp vascularity, such as Moyamoya disease surgery...

Treatment of Chronic Wound in a Patient with Systemic Vasculitis



Management of chronic wound has been a great problem to many surgeons because the wound is usually associated with an underlying disease of the patient. Without accurate diagnosis and treatment of the disease, the wound can not be healed. Systemic vasculitis is a rare systemic disease which causes inflammation and obstruction of the vessels. This autoimmune disease involves multiple organs and may inflict skin wound spontaneously without traumas. It would improve or aggravate the wound in proportion to the activities of the disease. Our experience is a case of 28-year-old female who has had chronic ulcers on her right foot, especially on the great toe for 1 year. Although she had several operations of sympathectomy, debridement and artificial dermal graft, her wound was not improved. She has been diagnosed as systemic vasculitis during the evaluation for histopathology and cause of fever and pancytopenia. After medical treatments, she had the operation of adipofascial turnover flap coverage and skin graft, and the wound was improved without any complication or relapse. The diagnosis and treatment of the underlying disease should be ahead of the management of chronic wound...

Erysipelas of the Upper Extremity Following Surgical Therapy for Breast Cancer



PURPOSE
Erysipelas is a bacterial infection of the dermis and hypodermis, mostly of streptococcal origin, and erysipelas of upper extremity following breast cancer treatment has never been reported in the Korean literature. METHODS: 39-year-old female presented to our hospital complaining of fever and painful swelling of her left upper extremity. She had a history of breast cancer and was treated with breast conserving surgery with axillary lymph node dissection, chemotherapy, and radiation. On physical examination, her left upper extremity showed vesicle, bullae, local heatness and erythema with well-defined margin. With these distinctive features of a skin lesion, we gave a diagnosis of erysipelas and started treatment with intravenous antibiotics. RESULTS: Resolution of the signs and symptoms of erysipelas occurred after 7 days of treatment. CONCLUSION: The diagnosis of erysipelas with distinctive feature of skin lesion is essential and we emphasize that the prevention of any trauma are very important in these patients for prophylactic measures...

A Case of Lipoma of the Parotid Gland



PURPOSE
Lipomas are common soft tissue neoplasms but are rarely found in the parotid gland. They constitute 1-3% of all parotid tumors, and are often not considered in the initial differential diagnosis of parotid gland tu mors. METHODS: Our experience is a case of 70-year-old male who had a slow growing, nontender parotid mass for 1 year. CT scan showed a well encapsulated mass with fat density in the superficial lobe of left parotid glan d. Lumpectomy including fatty mass and adjacent gland tissue was performed, preserving branches of facial nerve. RESULTS: Frozen section showed lipomatous lesion without malignancy, so, further treatment such as superfic ial parotidectomy was not needed. CONCLUSION: Though lipoma of parotid gland is rare, lipoma should be included in the initial differential diagnosis of parotid gland tumors and lumpectomy would be enough to treat lipoma if frozen section excluded the possibility of malignancy...

The usability of the upper eyelid crease approach for correction of medial orbital wall blowoutfracture.



BACKGROUND
There are many approaches to the medial orbital wall. However, most of them have problems with limitation of exposure, scarring, and postoperative inflammatory symptoms related to the eye. The authors u sed an upper eyelid crease approach to overcome these problems and investigate the usefulness of this approach.

METHODS
Between 2009 and 2011, the authors used this approach in 22 patients with medial orbit al wall fractures. Incisions were performed on the medial one-third of the crease and a 2- to 3-mm superomedial extension along a relaxed skin tension line.

RESULTS
Postoperative computed tomographic scans de monstrated complete reduction and accurate reconstitution of the bony defect in all cases. The initial two cases had revision to correct the implant position. Follow-up ranged from 8 to 28 months, with an average of 12 months. Complications related to the operation were not observed. Diplopia and limitation of eye movement resolved in most cases. Two patients had persistent diplopia for more than 6 months that decreased with time. Enophthalmos o f more than 2 mm was not observed in any orbit. The operative scar was inconspicuous.

CONCLUSIONS
This approach provides several advantages, including ease of exposure, and is more familiar to the plastic sur geon than the transconjunctival approach. There is little need to retract the globe laterally, thus minimizing postoperative inflammatory symptoms related to the eye. Therefore, the authors suggest that this method should be consi dered as a natural and useful surgical approach to medial orbital blowout fractures.

V-Y-Z plasty for correcting cryptotia.

The V-Y-Z plasty could cover the posterior auricular area sufficiently without causing any skin defects, and a normal auriculocephalic sulcus could be formed. We therefore think that V-Y-Z plasty is a useful method for the correction of cryptotia.

Aggressive Squamous Cell Carcinoma of the Scalp with Invasion into the Skull and Dura Mater.



PURPOSE
Squamous cell carcinoma of the scalp sometimes exhibits unusually aggressive behavior. We report a case of extradordinarily aggressive squamous cell carcinoma of the scalp with invasion into the skull and duramater.

Method
The patient is a 38-year-old man with two cystic masses on the occipital area. He was diagnosed as squamous cell carcinoma in that region and have undergone surgical resections including cortical osteotomy of the skull, several years ago. On this occasion, 3-dimensional computed tomographic imaging revealed an erosive lesion on the occipital bone and magnetic resonance imaging showed two cystic masses invasion into the skul l and dur a mater.

RESULTS
He has undergone wide resection of the masses and cranioplasty with dural repair. Histopathologic examination indicated squamous cell carcinoma with moderate differentiation of the masses, bone marrow and dura mater.

CONCLUSION
Squamous cell carcinoma on the scalp can readily penetrate the full thickness of the cranium and invade the dura mater, sagittal sinus and brain. We suggest wide resection of the scalp and split thickness skin graft with senti nel lymph node biopsy, following by postoperative radiation therapy.

Spindle Cell Lipoma of the Posterior Neck: A Case Report



PURPOSE
Spindle cell lipoma(SCL) is an uncommon subcutaneous soft tissue neoplasm that arises in the shoulder and posterior neck of older male patients. The imaging appearance of SCL is not pathognomonic and can display some features overlapping with liposarcoma. We report a case of SCL on the posterior neck.

METHODS
The patient is a 50-year-old man with a slowly enlarging subcutaneous mass on the right side of posterior neck. Computed tomographic imaging revealed a 7.0cm sized, well-circumscribed, heterogenous and fatty mass with enhanced solid components. Whole body Fluorine-18 Fluorodeoxyglucose Positron emission tomogram(FDG PET-CT) showed little increase of FDG uptake on the right posterior neck and there was no distant metastasis.

RESULTS
The mass was surgically removed. The resection margin was free of tumor on frozen biopsy. Histopathologic examination indicated spindle cell lipoma consisting of a mixture of mature adipocytes and uniform spindle cells wit hin a matrix of mucinous material.

CONCLUSION
Although CT image of the solitary mass in posterior neck is similar with the one of liposarcoma, we should consider that it may be a spindle cell lipoma if PET-CT and other systemic studies reveal no distant metastasis. And we should perform fine needle aspiration to differentiate SCL from malignant lesions

A case of DiGeorge syndrome with metopic synostosis



PURPOSE
We report a patient with DiGeorge syndrome who was later diagnosed as mild metopic synostosis and received anterior 2/3 calvarial remodeling.

METHODS
A 16-month-old boy, who underwent palatoplasty for cleft palate at Chungnam National University Hospital when he was 12 months old of age, visited St. Mary's Hospital for known DiGeorge syndrome with craniosynostosis. He had growth retardation and was also diagnosed with hydronephrosis and thymic agenesis. His chromosomal study showed microdeletion of 22q11.2. On physical examination, there were parieto-occipital protrusion and bi frontotemporal narrowing. The facial bone computed tomography showed premature closure of metopic suture, orbital harlequin sign and decreased anterior cranial volume. The interorbital distance was decreased(17mm) an d the cephalic index was 93%.

RESULTS
After the correction of metopic synostosis by anterior 2/3 calvarial remodeling, the anterior cranial volume expanded with increased interorbital distance and decreased cephalic index. Fever and pancytopenia were noted at 1 month after the operation, and he was diagnosed as hemophagocytic lymphohistiocytosis by bone marrow study. He however, recovered after pediatric treatment. There was no other complication during the 12 month follow up period.

CONCLUSION
This case presents with a rare combination of DiGeorge syndrome and metopic synostosis. When a child is diagnosed with DiGeorge syndrome soon after the birth, clinicians should keep in mind the possibility of an accomp anying craniosynostosis. Other possible comorbidities should also be evaluated before the correction of craniosynostosis in patients as DiGeorge syndrome. In addition, postoperative management requires a thorough follow u p by a multidisciplinary team of plastic surgeons, neurosurgeons, ophthalmologists and pediatricians

Immediate microsurgical reconstruction of the distal digit injury with short vascular pedicled partial toe transfer.



We studied the results of the immediate microsurgical reconstruction of the distal digit injury with short vascular pedicled partial toe transfer. Thirteen patients with amputation or crush injury of the distal digit who underwent pa rtial toe transfer at the authors' institute over 8-year period were reviewed. Delay between initial injury and reconstruction ranged from 1 to 9 days. All flaps were harvested on a short vascular pedicle, with anastomoses performed at a proximal interphalangeal joint level on the fingers and metacarpophalangeal joint level on the thumbs. Good to excellent cosmetic and functional results were obtained in all cases, with nearly normal-looking fingertip. The mean static tw o point discrimination was 10 mm. Immediate reconstruction with short vascular pedicled partial toe transfer is an excellent option for the reconstruction of the compostie defect of the distal digit.

A Case Report of Glomus Tumor of the Nasal Columella.



PURPOSE
Glomus tumor is a benign neoplasm of the normal glomus body, occurring as painful subcutaneous nodules, frequently located in the subungual area. There are few cases of facial glomus tumor reported and we report a case of glomus tumor developing on the columella of nose.

METHODS
A 68-year-old female presented with a mass of the columella grown for 2 years. The nodule was 0.6 cm in diameter, red-colored without any symptoms such as pain, tenderness and cold hypersensitivity. The pathologic result af ter punch biopsy was hemangiopericytoma. Excision with local anesthesia was executed.

RESULTS
The postoperative recovery of the patient was uneventful, Histopathological examination indicated a glomus tumor. Immunostaining revealed positivity for vimentin, actin, and negativity for desmin, CD-34. After 8 months follow u p, there is neither complication nor evidence of local recurrence on clinical examination.

CONCLUSION
To accomplish an accurate diagnosis of glomus tumor, the histopathological examination is essential together with immunochemical studies. The differential diagnosis include hemangioma, lipoma, epidermal inclusion cyst, derm oid cyst and arteriovenous malformation in this region. We report a case of glomus tumor on the face with uncommon clinical features.